General Question

tranquilsea's avatar

Is it possible to be in liver failure and still have normal liver function?

Asked by tranquilsea (17739points) December 15th, 2010

I know there is a gradation of liver failure and that the liver is a resilient organ. At the beginning of liver failure could you still have normal liver function and have your liver test as being normal?

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11 Answers

Dr_Dredd's avatar

There are degrees of liver injury, especially with chronic problems like alcoholic liver disease or hepatitis C. At the beginning, yes, liver function tests such as AST or ALT will be normal. (One of the more sensitive things to check is actually a blood coagulation test called protime, which is affected by proteins produced by the liver.) Over time, though, liver function will decline, eventually irreversibly.

nicobanks's avatar

Maybe you should give us more detail. I mean, on the surface, your question doesn’t make much sense: a healthy liver and liver disease are mutually exclusive conditions. Like how a fresh apple and a rotten apple are mutually exclusive: no apple can be both. No liver can be healthy and diseased.

Again, I don’t know the whole story, but if your liver tests normal then you have nothing to worry about except for current behaviours and conditions that could lead to liver failure in the future. E.g. If you drink like a fish your liver may well be healthy now, but it certainly won’t stay that way if you keep it up.

Dr_Dredd's avatar

@nicobanks Actually, the routine tests for liver function may not show a problem until the liver is significantly diseased. So if you do bloodwork earlier than that, the results can be normal. The most accurate way to diagnose and determine the stage of liver disease is a biopsy. The problem, obviously, is that it is an invasive procedure with its own risks. So unless there is a compelling reason, doctors will stick with the bloodwork and counsel against behaviors that could increase liver disease risk (e.g. drinking like a fish).

JLeslie's avatar

My two cents is besides drinking, if you have reason for concern, don’t take Tylenol, aceitomenophine, and other medications that tax your liver, unless necessary. People think of Tylenol as the safest pain reliever, but it is one of the worst on your liver OTC. Never take Tylenol and alcohol together, or to treat a hangover.

cheebdragon's avatar

liver failure doesn’t sound “normal”...

Lightlyseared's avatar

@JLeslie paracetamol is the safest pain relief you can take. NSAID’s like ibuprofen also cause damage to the liver and while it safe to give a patient in liver failure paracetamol (sometimes at a reduced dose but not neccasrily) it is not safe to give an NSAID. Yes it can cause liver damage if you take too much and yes the difference between the theraputic dose and the toxic dose is smaller then some other medications but it is one of the MOST effective analgesics out there and billions of people take it every day with out managing to kill themselves.

JLeslie's avatar

@Lightlyseared The way I remember it NSAIDs are more associated with kidney and heart trouble. I would guess it very possible they can tax the liver as well, but aceitomenophine has always been the big stand out for causing liver damage in the US regarding OTC medication in my mind. I’ll have to google a little and see what it actually says out there. I am going by what I have been told over the years. Are you a doctor? Pharmacist?

JLeslie's avatar

I found this which does say NSAIDs can cause liver problems, but does dwell on liver related stats for acetomenophen.

Nevertheless, acetaminophen overdose is one the most common causes of OTC drug poisoning in the United States and Britain. More than 30,000 cases per year of acetaminophen overdose are reported to the American Association of Poison Control Centers (Bartlett D 2004). It is a leading cause of liver failure in the Western world and the leading cause of drug-induced liver failure in the United States (Bartlett D 2004).

What is unclear is if acetaminophen is taken much more often than NSAIDs in general, hence resulting in higher statistical instances of liver problems compared to other OTC drugs, but not a fair apples to apples comparison of instances per doses taken.

Lightlyseared's avatar

@JLeslie I’m not saying that acetaminophen won’t cause liver disease. I work in a large liver transplant centre and know that it’s the number 1 reason for acute liver failure and the number 1 reason for super urgent transplant. Long term use can also cause liver damge which is why if you’re taking it every day you need to make sure you see your doc for regular checks. But your claim that it’s not the safest OTC pain killer is not true.

tranquilsea's avatar

Thanks for all the replies.

JLeslie's avatar

@Lightlyseared OK. Although, you seem to be agreeing it is the number one cause of accute liver failure. Is it number one because more people take tylenol over other pain killers then? Is that what you are saying? I am glad you said something about the NSAIDs also.

I think at least the OP can take away not to take pain killers like candy if she is concerned about her liver.

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